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Anemia in CKD

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https://www.readbyqxmd.com/read/29138677/oxidative-stress-in-hemodialysis-patients-a-review-of-the-literature
#1
REVIEW
Vassilios Liakopoulos, Stefanos Roumeliotis, Xenia Gorny, Evangelia Dounousi, Peter R Mertens
Hemodialysis (HD) patients are at high risk for all-cause mortality and cardiovascular events. In addition to traditional risk factors, excessive oxidative stress (OS) and chronic inflammation emerge as novel and major contributors to accelerated atherosclerosis and elevated mortality. OS is defined as the imbalance between antioxidant defense mechanisms and oxidant products, the latter overwhelming the former. OS appears in early stages of chronic kidney disease (CKD), advances along with worsening of renal failure, and is further exacerbated by the HD process per se...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29134616/zonulin-inflammation-and-iron-status-in-patients-with-early-stages-of-chronic-kidney-disease
#2
Ewelina Lukaszyk, Mateusz Lukaszyk, Ewa Koc-Zorawska, Anna Bodzenta-Lukaszyk, Jolanta Malyszko
BACKGROUND/AIMS: Zonulin is the only known regulator of intestinal permeability. It is also considered as a potential inflammatory marker in several conditions such as diabetes and inflammatory bowel syndrome. The aim of the study was to investigate zonulin levels in patients with early stages of CKD and its possible correlation with inflammation, anemia and iron status parameters. METHODS: Eighty-eight patients with early stages of CKD and 23 healthy volunteers were enrolled in the study...
November 13, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/29132915/human-recombinant-erythropoietin-reduces-sensorimotor-dysfunction-and-cognitive-impairment-in-rat-models-of-chronic-kidney-disease
#3
E E Reza-Zaldívar, S Sandoval-Avila, Y K Gutiérrez-Mercado, E Vázquez-Méndez, A A Canales-Aguirre, H Esquivel-Solís, U Gómez-Pinedo, A L Márquez-Aguirre
INTRODUCTION: Chronic kidney disease (CKD) can cause anaemia and neurological disorders. Recombinant human erythropoietin (rHuEPO) is used to manage anaemia in CKD. However, there is little evidence on the effects of rHuEPO on behaviour and cognitive function in CKD. This study aimed to evaluate the impact of rHuEPO in sensorimotor and cognitive functions in a CKD model. METHODS: Male Wistar rats were randomly assigned to 4 groups: control and CKD, with and without rHuEPO treatment (1050 IU per kg body weight, once weekly for 4 weeks)...
November 10, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29127652/dapagliflozin-as-a-cause-of-acute-tubular-necrosis-with-heavy-consequences-a-case-report
#4
Christos Pleros, Elisavet Stamataki, Antonia Papadaki, Nikolaos Damianakis, Rafaela Poulidaki, Charikleia Gakiopoulou, Ioannis Tzanakis
A 50-year-old man with type II diabetes, hypertension and dyslipidemia, presented with non-oliguric acute kidney injury (AKI) and anemia. Renal biopsy showed acute tubular necrosis (ATN) with extensive cytoplasmic vacuolization and areas of tubulitis. These findings were ultimately attributed to dapagliflozin, which he started 3 months earlier due to poor glycemic control. ATN with similar microscopic findings has been described with larger doses of dapagliflozin in non-clinical trials. Our patient was started on dialysis and remained dialysis-dependent for 4 weeks while his renal function improved gradually thereafter...
November 10, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/29109065/the-impact-of-chronic-kidney-disease-on-post-operative-outcomes-in-patients-undergoing-lumbar-decompression-and-fusion
#5
Owoicho Adogwa, Aladine A Elsamadicy, Amanda Sergesketter, Deborah Oyeyemi, Diego Galan, Victoria D Vuong, Syed Khalid, Joseph Cheng, Carlos A Bagley, Isaac O Karikari
BACKGROUND: Little is known of the impact of pre-operative chronic kidney disease (CKD) on post-operative complications in patients undergoing lumbar arthrodesis. The aim of this study is to determine whether pre-operative CKD is associated with inferior peri-operative outcomes. METHODS: The medical records of 293 adult (≥18 years-old) spine deformity patients undergoing elective lumbar spine decompression and fusion at a major academic institution from 2006 to 2015 were reviewed...
November 3, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29097481/efficacy-and-long-term-safety-of-c-e-r-a-maintenance-in-pediatric-hemodialysis-patients-with-anemia-of-ckd
#6
Michel Fischbach, Elke Wühl, Sylvie C Meyer Reigner, Zoe Morgan, Franz Schaefer
BACKGROUND AND OBJECTIVES: The study was conducted to identify a conversion factor for switching from previous erythropoiesis-stimulating agents (ESAs) to continuous erythropoietin receptor activator-methoxy polyethylene glycol-epoetin beta (C.E.R.A.) and to document the efficacy and long-term safety of C.E.R.A. in pediatric patients with anemia of CKD undergoing hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this open-label, multicenter study, patients aged 6-17 years, with stable chronic anemia of CKD, undergoing hemodialysis received C...
November 2, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29092739/erythropoietic-response-to-oral-iron-in-patients-with-nondialysis-dependent-chronic-kidney-disease-in-the-find-ckd-trial%C3%A2
#7
Iain C Macdougall, Andreas H Bock, Fernando Carrera, Kai-Uwe Eckardt, Carlo Gaillard, David Van Wyck, Yvonne Meier, Sylvain Larroque, Amandine Perrin, Simon D Roger
AIMS: To evaluate erythropoietic response rates to oral iron over time in iron-deficient anemic patients with nondialysis-dependent chronic kidney disease (ND-CKD). MATERIALS AND METHODS: FIND-CKD was a 1-year, randomized, multicenter trial of iron therapy in patients with ND-CKD, anemia, and iron deficiency, without erythropoiesis-stimulating agent (ESA) therapy. Patients with active infection or C-reactive protein > 20 mg/L were excluded. In this post-hoc analysis, response was defined as ≥ 1 g/dL increase in hemoglobin (Hb) from baseline, before initiation of alternative anemia therapy (i...
October 26, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29084409/a-comparison-of-the-safety-and-efficacy-of-hx575-epoetin-alfa-proposed-biosimilar-with-epoetin-alfa-in-patients-with-end-stage-renal-disease
#8
Matthew R Weir, Pablo E Pergola, Rajiv L Agarwal, Jeffrey C Fink, Nelson P Kopyt, Ajay K Singh, Jayant Kumar, Susanne Schmitt, Gregor Schaffar, Anita Rudy, Jim P McKay, Radmila Kanceva
BACKGROUND: HX575 (biosimilar epoetin alfa) was approved in Europe in 2007 for the treatment of chronic kidney disease (CKD)-related anemia. This study assessed the clinical equivalence of HX575 with the US-licensed reference epoetin alfa (Epogen®/Procrit®, Amgen/Janssen) following subcutaneous (SC) administration in dialysis patients with CKD-related anemia. METHODS: This randomized, double-blind, parallel-group, multicenter study (NCT01693029) was conducted at 49 US clinical sites...
October 30, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29077007/altered-metabolism-of-blood-manganese-is-associated-with-low-levels-of-hemoglobin-in-patients-with-chronic-kidney-disease
#9
Minyoung Kim, Eun Sil Koh, Sungjin Chung, Yoon Sik Chang, Seok Joon Shin
Blood manganese (Mn) level has been reported to be higher in patients with anemia or iron deficiency. The purpose of this study was to analyze the relationship between blood Mn level and anemia in patients with chronic kidney disease (CKD). A total of 334 patients with CKD who were not treated with dialysis were included in this study. Blood Mn level and serum markers regarding anemia, renal function, and nutrition were measured and analyzed. Median blood Mn level was 8.30 (interquartile range(IQR): 5.27-11...
October 27, 2017: Nutrients
https://www.readbyqxmd.com/read/29074377/dual-therapeutic-effects-of-an-albumin-based-nitric-oxide-donor-on-two-experimental-models-of-chronic-kidney-disease
#10
Shun Oshiro, Yu Ishima, Maeda Hitoshi, Naoko Honda, Bi Jing, Ryo Kinoshita, Mayumi Ikeda, Yasunori Iwao, Tadashi Imafuku, Kento Nishida, Sigeyuki Miyamura, Hiroshi Watanabe, Masaki Otagiri, Toru Maruyama
Chronic kidney disease (CKD) is accompanied by a variety of complications, typically renal anemia and kidney fibrosis. Accordingly, it is desirable to develop the novel therapeutics that can treat these CKD conditions. Since nitric oxide (NO) has multiple functions including hypoxia inducible factor (HIF) stabilizing, anti-inflammatory, anti-oxidative and anti-apoptoic activities, the use of NO for the CKD therapy has attracted considerable interest. Here, we evaluate the therapeutic impacts of S-nitrosated human serum albumin (SNO-HSA), a long-lasting NO donor, on two animal models of CKD...
October 23, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29044949/induction-of-erythropoietin-gene-expression-in-epithelial-cells-by-chemicals-identified-in-gata-inhibitor-screenings
#11
Hiroshi Kaneko, Takehide Katoh, Ikuo Hirano, Atsushi Hasegawa, Tadayuki Tsujita, Masayuki Yamamoto, Ritsuko Shimizu
Erythropoietin (EPO) is a hormone that promotes proliferation, differentiation and survival of erythroid progenitors. EPO gene expression is regulated in a tissue-specific and hypoxia-inducible manner and is mainly restricted to renal EPO-producing cells after birth. Chronic kidney disease (CKD) confers high risk for renal anemia due to lower EPO production from injured kidneys. In transgenic reporter lines of mice, disruption of a GATA-binding motif within the Epo gene promoter-proximal region restores constitutive reporter expression in epithelial cells...
October 18, 2017: Genes to Cells: Devoted to Molecular & Cellular Mechanisms
https://www.readbyqxmd.com/read/29033600/efficacy-and-safety-of-subcutaneous-administration-of-lyophilized-powder-of-alfa-erythropoietin-to-maintain-hemoglobin-concentrations-among-hemodialysis-patients
#12
Bancha Satirapoj, Rattanawan Dispan, Ouppatham Supasyndh
BACKGROUND: Anemia associated with chronic kidney disease (CKD) often requires treatment with recombinant human erythropoietin (EPO). This study investigated the therapeutic equivalence between lyophilized powder and standard liquid EPO alfa by subcutaneous (SC) administration in hemoglobin maintenance among patients on hemodialysis. METHODS: This was a single-blinded, randomized, controlled, single-center, parallel-group study regarding the treatment of anemia among CKD patients on hemodialysis and being treated with stable doses of EPO alfa at least for 12 weeks...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/29033594/cost-effectiveness-analysis-of-intravenous-ferumoxytol-for-the-treatment-of-iron-deficiency-anemia-in-adult-patients-with-non-dialysis-dependent-chronic-kidney-disease-in-the-usa
#13
Naomi V Dahl, Robert F Kaper, William E Strauss, Frank A Corvino, Marko Zivkovic
OBJECTIVE: Ferumoxytol has demonstrated superior efficacy compared with oral iron in treating iron deficiency anemia in chronic kidney disease (CKD) patients. However, an economic evaluation of ferumoxytol has not been conducted. The aim of this study was to analyze the cost-effectiveness of treating iron deficiency anemia in adult non-dialysis-dependent CKD patients with ferumoxytol as compared with oral iron, alone or in combination with erythropoietin-stimulating agents (ESAs). METHODS: A decision analytic model compared health outcomes and costs associated with 5-week outpatient treatment of adult non-dialysis-dependent CKD patients with ferumoxytol or oral iron, each as monotherapy or in combination with ESAs in the USA...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29029600/clinical-features-and-ckd-related-quality-of-life-in-patients-with-ckd-g3a-and-ckd-g3b-in-china-results-from-the-chinese-cohort-study-of-chronic-kidney-disease-c-stride
#14
Zhangzhe Peng, Jinwei Wang, Qiongjing Yuan, Xiangcheng Xiao, Hui Xu, Yanyun Xie, Wei Wang, Ling Huang, Yong Zhong, Xiang Ao, Luxia Zhang, Minghui Zhao, Lijian Tao, Qiaoling Zhou
BACKGROUND: This study aimed to compare clinical features and health-related quality of life (HRQoL) in the Chinese chronic kidney disease (CKD) 3 population and determined the necessity of the subdivision of CKD3 in Chinese patients with CKD. METHODS: Participants with stage 3 CKD (18-74 years of age) were recruited at 39 clinical centers located at 28 cities in 22 provinces of China. The sociodemographic status, medical history, anthropometric measurements, and lifestyle behaviors were documented at entry, and blood and urine samples were collected...
October 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28992067/the-uremic-toxin-indoxyl-sulfate-interferes-with-iron-metabolism-by-regulating-hepcidin-in-chronic-kidney-disease
#15
Hirofumi Hamano, Yasumasa Ikeda, Hiroaki Watanabe, Yuya Horinouchi, Yuki Izawa-Ishizawa, Masaki Imanishi, Yoshito Zamami, Kenshi Takechi, Licht Miyamoto, Keisuke Ishizawa, Koichiro Tsuchiya, Toshiaki Tamaki
Background: Hepcidin secreted by hepatocytes is a key regulator of iron metabolism throughout the body. Hepcidin concentrations are increased in chronic kidney disease (CKD), contributing to abnormalities in iron metabolism. Levels of indoxyl sulfate (IS), a uremic toxin, are also elevated in CKD. However, the effect of IS accumulation on iron metabolism remains unclear. Methods: We used HepG2 cells to determine the mechanism by which IS regulates hepcidin concentrations...
August 23, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28982638/prospective-cohort-analyzing-risk-factors-for-chronic-kidney-disease-progression-in-children
#16
Vera M S Belangero, Liliane C Prates, Andreia Watanabe, Benita S G Schvartsman, Paula Nussenzveig, Natalia A Cruz, Ana L S Abreu, Isabel P Paz, Inalda Facincani, Fernanda E C Morgantetti, Andreia O Silva, Olberes V B Andrade, Maria F C Camargo, Paulo C Koch Nogueira
OBJECTIVE: To identify risk factors for chronic kidney disease progression in Brazilian children and to evaluate the interactions between factors. METHODS: This was a multicenter prospective cohort in São Paulo, involving 209 children with CKD stages 3-4. The study outcome included: (a) death, (b) start of kidney replacement therapy, (c) eGFR decrease >50% during the followup. Thirteen risk factors were tested using univariate regression models, followed by multivariable Cox regression models...
October 2, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28978825/pathogenesis-and-treatment-of-anemia-in-chronic-kidney-disease
#17
Masaomi Nangaku
Chronic kidney disease leads to dysfunction of renal erythropoietin-producing cells, resulting in a decrease in erythrocyte production. A decrease in oxygen delivery to vital organs due to anemia results in worse quality of life and is associated with poor prognosis of the patients. Treatment with human recombinant erythropoietin or its improved version of erythropoiesis-stimulating agent (ESA) with a longer half-life is effective. However, some patients show hyporesponsiveness to ESA. Hyporesponsiveness to ESA, which can be induced by factors such as inflammation and uremic toxins, is associated with poor prognosis...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28963827/-iron-deficiency-in-nd-ckd-from-diagnosis-to-treatment
#18
REVIEW
Maria Elena Liberti, Carlo Garofalo, Adelia Sagliocca, Silvio Borrelli, Giuseppe Conte, Luca De Nicola, Roberto Minutolo
In non-dialysis-chronic kidney disease (CKD), iron deficiency is a frequent nutritional disorder due to either the greater tendency to occult gastrointestinal bleeding or to the chronic inflammatory state resulting in a reduced intestinal iron reabsorption through an increased synthesis of hepcidin. These phenomenon are responsible for a negative iron balance that compromises erythropoiesis and contributes to the pathogenesis of anemia in CKD. Several laboratory tests are now available to allow an adequate diagnosis of iron deficiency...
September 28, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28957817/altered-expression-pattern-of-cd55-and-cd59-on-red-blood-cells-in-anemia-of-chronic-kidney-disease
#19
Lama Al Faris, Salah Al-Humood, Fatma Behbehani, Husam Sallam
OBJECTIVE: To investigate the expression pattern of CD55 and CD59 on red blood cells (RBCs) in anemic chronic kidney disease (CKD) patients, and factors that might infleunce their expression. SUBJECTS AND METHODS: Nighty one adult anemic CKD patients and 80 healthy controls (HC) were enrolled. Anemic CKD patients were divided into 3 subgroups based on receiving erythropoietin (EPO) and renal replacement therapies (RRT). Flow cytometric analysis of CD55 and CD59 expression was performed on RBCs from blood samples obtained from CKD patients and HC...
September 28, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/28954928/human-pluripotent-stem-cell-derived-erythropoietin-producing-cells-ameliorate-renal-anemia-in-mice
#20
Hirofumi Hitomi, Tomoko Kasahara, Naoko Katagiri, Azusa Hoshina, Shin-Ichi Mae, Maki Kotaka, Takafumi Toyohara, Asadur Rahman, Daisuke Nakano, Akira Niwa, Megumu K Saito, Tatsutoshi Nakahata, Akira Nishiyama, Kenji Osafune
The production of erythropoietin (EPO) by the kidneys, a principal hormone for the hematopoietic system, is reduced in patients with chronic kidney disease (CKD), eventually resulting in severe anemia. Although recombinant human EPO treatment improves anemia in patients with CKD, returning to full red blood cell production without fluctuations does not always occur. We established a method to generate EPO-producing cells from human induced pluripotent stem cells (hiPSCs) by modifying previously reported hepatic differentiation protocols...
September 27, 2017: Science Translational Medicine
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